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rj 1 �o out�a+esapea�erAe•riw�wu u�� ��� <br /> 1-1 819 Striker Ave,Suite$ Sacramento CA 95834-(916)921 U East 11115 Montgo�Suite". poka"A 9909)4pwu VIUAT <br /> 1 <br /> Q404 N W,get Lane•Wainut Creek CA 94598•(510)988 960 - U 15055 S W Sequoia Pkwy Suite 110•Portiand OR 97222•(503)624 989 <br /> nsultant Company t ti L�nV C p Project Name 511 r/TY IV <br /> Jdressr� UNOCAL Project Manager -e "10 2 7� - 3S <br /> ity � ?5 e StatZip Code fs//� AFE # <br /> �. c <br /> elephone Zf - 75, V 7 FAX# <br /> `7�3 site #, City, State 6 P to S-44 q 'S fibc v <br /> �e ort To ISampler_ K j �/ l 10C Data (•� LEVe1 D (Standard) FJLevel C QLeve1 S ❑ Level A <br /> urnaround rff10 Wor ays IJ 5 Work Days IJ 3 Work Da` s u Drinking Water , Ana) ses tie uested Q <br /> tme ❑ 2 Work Das U i Work Day U 2-8 Hours IJ Waste Water. <br /> BODE` IJ Misc 1] Detect PJfval U Remed ❑ Demol IJ Closure dOther <br /> Client Date/Trme Matrix # of Cont Laboratory ��� � ,� ► <br /> Sample f D Sampled Desc Cont Type Sample # Comments <br /> J <br /> � I <br /> P ZiSC V t l <br /> L'_ a <br /> 5 �- <br /> 6 <br /> 3 <br /> 7 <br /> 8 <br /> 9 <br /> a <br /> 10 <br /> s � <br /> tcs <br /> Relinquished 8y Date Time S' Received 8 ',•. ' Date II Time 5' <br /> a� <br /> Relinquished ( Date Time Received Dater 17 Time ��a <br /> Relin uished B L Date C� Time Received 8 Lab Date ' �� ime <br /> R aizipleS ec ivh in 0�drtr n1_1? D Yes'XIf�J Ko Samples on Ice? rJ Yes rl No Method of Shipment + Page oft <br /> mpleted upon receipt o report <br /> QFe the analyses requested on the Chain of Custody reported? FJ Yes❑ No if no, what analyses are still needed? <br /> z �a report issued within the requested turnaround time? IJ Yes t1 No If no,what was the turnaround time? <br /> Signature __ _� __ _ Company Date <br />